Making Connections:
Children and Frail Elders
FS 327
Reprinted April 1999
C. Pratt and G. Alger
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Interactions between children and the frail elderly can
benefit both generations. Children can gain an understanding
of aging and develop meaningful relationships with older persons.
Frail elders can enjoy the happiness and satisfaction of a relationship
with a child.
Within families, visits between frail elders and children
can be especially important. Such visits help children and frail
loved ones stay connected. When a relative is very ill or dying,
parents may feel uneasy allowing a child to visit. Although it's
natural for a parent to want to protect a child from sadness,
remaining connected with a frail relative can help the child
learn about aging, loving, and caring.
Positive visits
The most positive outcomes of visits between children
and the frail elderly occur when children are interacting with
and learning about both active and frail elders, and when children
are prepared and supported. If children know only very
frail elders, they are more likely to believe that all elderly
people are frail. In fact, most elders live 20 or 30 years past
retirement in relatively good health. Only 20% of older people
need regular assistance, and only 5% live in long-term care facilities.
Interactions with both frail and active elders can help children
understand the great differences found among older people.
Creating positive interactions
Teachers, youth group leaders, and parents can create
positive visits between children and the frail elderly. Five
steps are always important:
1. Think about your attitudes about aging.
Before you arrange visits between children and frail elders,
answer the following questions:
- What do you know about aging? Are you willing to learn
more in order to help children have a positive experience with
the frail elders?
- What do you remember about past experiences with the
frail elderly? Which experiences were positive or negative for
you? What made these experiences positive or negative?
2. Know the purpose of the visit. What
do you want the children to gain from the visit? How will the
interaction benefit both elder and child? Can both elder and
child participate? Are you willing to prepare and support children?
Will you address children's questions and concerns?
3. Design visits that create interaction.
Well-designed visits can help children learn about the special
needs and resources of individual elders. The best visits are
built around shared experiences that both the older person
and child can enjoy. The best interactions:
- Emphasize one-to-one or small group interaction
- Provide a shared experience such as petting a puppy,
looking at photos, playing a game, celebrating an event, going
for a walk, telling stories about the past, or other activities
- Recognize the frail elders' limitations, if any; short,
frequent visits are often better than longer, but infrequent
(or "one-shot") visits
- Allow the elder to say when he or she prefers to visit
or to decline visits
- Finally, remember the importance of touch and music.
It can be wonderful for a frail elder and a child to share a
gentle hug, a handshake, or an arm around the shoulder. A singing
voice or sharing a familiar song can bring pleasant memories.
4. Prepare and support the children.
Learn what the children believe. Before the first visit,
find out what the children believe about aging and the frail
elderly. One way to do this is to ask, "What ideas or words
do you think of when I say 'old'?" "How does a grandpa
look?" "What will you do every day when you are old?"
Children may want to draw pictures or write stories about their
experiences with older people. Children of all ages may want
to share ideas about body changes, illness, or death. Discuss
the children's ideas and talk about the diversity of the elderly.
Describe the experience. If the elderly
person you'll be visiting is ill, children should be given a
simple explanation of the illness. For school-age children and
teens, the explanations may be more detailed. Reassure the children
that they cannot "catch" diseases during visits. If
the elder uses a wheelchair, walker, or hearing aid, explain
and, if possible, demonstrate the uses of this equipment.
If the older person lives in a nursing home, describe
the various sounds, smells, and sights that might be encountered.
For example, you might say, "Try not to be frightened if
you hear someone yell. A yell can be like a sneeze. Some old
people can't help yelling just like sometimes you can't help
sneezing." Or, "You may smell the chemicals used for
cleaning." Children should be told that many of the people
who live in the nursing home may not be feeling well, so it's
important to be calm.
Respond to children's concerns. Encourage
children to ask questions or talk about their feelings before
and after a visit. Answer all questions as honestly and thoroughly
as you can. After visits, encourage children to talk about their
experiences.
Rehearse a visit. Role playing a visit,
especially a first visit, can help children understand some of
the problems faced by frail older people. Role playing also can
help children talk about their ideas and feelings about aging.
Because role playing can be a powerful way to teach, it's important
to remind children that most older people are not frail and that
people who have limitations usually adapt to them.
Some older people experience partial or complete loss
of vision, hearing, or other senses. It's helpful for children
to understand these losses. Demonstrate these losses by having
children eat or watch TV while blindfolded or while wearing glasses
smeared with petroleum jelly. Tape recorders set on low volume
can sound like hearing loss.
Discuss how to respond to these changes. For example,
to improve communication with someone who has a hearing loss,
children should speak clearly, face the person, repeat sentences
patiently if needed, and avoid "slang" words. Other
ideas for learning about sensory changes are found in "For
more information" at the end of this page.
5. Plan for special circumstances.
Some situations require special attention. These include visits
to relatives who are very ill or who live far away, visits to
someone with dementia, or the death of an elderly friend or relative.
Declining health. Visits may be difficult
when an elderly friend's or relative's health declines. Comments
such as "Remember Grandpa as he was, not as he is"
can confuse children. Children need to be prepared for what they
might see. Explain the elder's physical and mental condition
and use of any medical equipment. Remind the children that the
elder person can be comforted by their visit, even if the person
cannot respond.
Long-distance relatives. Connections
between a child and a long-distance relative can be a challenge.
Encourage the child and the elder to stay in touch by telephone
or by mail between visits. Weekly or monthly postcards with one
or two sentences or a small drawing may be all that is needed.
If visits are possible, prepare the child for physical and mental
changes that may have occurred.
Dementia. Major declines in memory
and learning ability are not the result of normal aging.
Some persons, however, develop dementia, which causes brain damage
and leads to serious declines in memory, attention, and judgment.
Alzheimer's disease is the most common dementia. Dementia usually
progresses from memory loss to the inability to care for oneself.
Depending on the stage of the disease, persons with dementia
may:
- Forget who people are
- Lose the ability to care for themselves
- Feel angry or depressed because of their losses
- Cry, laugh, stare, or withdraw without a clear reason
- Talk about people or events in their past as if they
were happening now.
A caring environment is important to persons with dementia.
Reassure children that they can comfort the elder even if the
person doesn't seem to know them or confuses them with someone
else. Remind children to introduce themselves at the beginning
of every visit. Leaving notes with the elder can be a gentle
reminder of visits. Several of the publications listed at the
end of this fact sheet offer other ideas for improving visits
to persons with dementia.
Death of a relative or friend. Death
is a reality of life. Children cannot be protected from this
reality but they can be supported in their grief. If a death
is anticipated, talk about it before it occurs. You support children
when you encourage them to share their feelings and memories
and to ask questions; listen and respond to these. Remind them
that it's normal to feel very sad when someone dies, and that
happiness will come again.
A child may want to attend a funeral or to remember the
person who has died in some other way. Launching balloons, drawing
pictures of times they want to remember, attending religious
ceremonies that are part of the child's tradition, or
other activities can be important ways of saying goodbye. Children
may suffer when a frail elder dies. Adults can help make the
reality of death easier by offering support.
Summary
You can design positive visits between children and frail
elderly if you:
- Know your attitudes
- Know the purpose of the visit
- Design visits to encourage interaction
- Prepare and support the children
- Consider special circumstances.
Prepared by Clara Pratt,
Knudson Endowed Chair in Family Policy, Family Study Center,
Oregon State University; and Georgina Alger, M.S., case manager,
Senior Services, Cascades West Council of Governments.
Published
May 1995. Reprinted April 1999.
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